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General2h ago

AI Medicare Review Program Delays Care for Washington Seniors

Oregon Public Broadcasting - OPB1 min brief

In brief

  • Washington seniors face denied or delayed care under a pilot program that uses AI to review Medicare procedure requests.
  • The program aims to reduce fraud and waste by requiring prior authorization for certain procedures.
    • It has incentivized private companies to deny procedures, with over 1.5 million Medicare enrollees in Washington state affected.
  • The program's use of AI to review claims is causing concerns among advocates, with reports of patients waiting two to four times longer for procedure authorizations.
  • The repeal effort will continue to gain momentum in the coming months.

Read full story at Oregon Public Broadcasting - OPB

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